SYSTEM FOR MULTIMODALITY FUSION OF IMAGING DATA BASED ON STATISTICAL MODELS OF ANATOMY
A ventricular epicardium registration method (60) involves three phases. The first phase (P62) is an identification of one or more anatomical features invisible within ultrasound images (41) of a ventricular epicardium of a heart (10). The second phase (P61) is a representation of the anatomical feature(s) visible within X-ray images (31) of the ventricular epicardium of the heart. The third phase (P63) is a registration of the ultrasound images (41) and the X-ray images (31) of the ventricular epicardium of the heart based on the representation of the anatomical feature(s) invisible in the ultrasound images (41) and on the identification of the anatomical feature(s) visible within the X-ray images (31). Examples of the anatomical feature(s) include, but are not limited to, a portion or an entirety of an epicardial surface (11, 12) and a coronary sinus vein (13).
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Applicant claims benefit of U.S. Provisional Application Ser. No. 61/014,451, filed Dec. 18, 2007. Related applications are U.S. Provisional Application Ser. No. 61/014,455, filed Dec. 18, 2007 and U.S. Provisional Application Ser. No. 61/099,637, filed Sep. 24, 2008.
The present invention relates to methods and systems for integrating cardiac three-dimensional X-ray and ultrasound information based on anatomical features (e.g., epicardial surfaces and landmarks) within X-ray and ultrasound images of a ventricular epicardium of a heart.
Patients undergoing cardiac interventions are typically extremely fragile and are in heart failure. They are often unable to tolerate large volume contrast injections that are typical of procedures such as, for example, a ventriculography. In some of these scenarios, multimodal image-based registration requiring ventriculography cannot ethically be performed.
For example, cardiac resynchronization therapies rely on the implantation of biventricular pacer leads in the right and left heart chambers. To synchronize cardiac contraction, the left ventricular lead position is manipulated within the coronary venous anatomy to position the electrode tip within the region of greatest mechanical delay. Three-dimensional vein models derived from rotational venograms help the physician to identify promising vein branches for lead navigation, whereas dyssynchrony assessment based on three-dimensional ultrasound imaging helps identify the target location for electrode tip placement. To effectively utilize information from X-ray and ultrasound, a registration (i.e., a spatial alignment) between the X-ray and ultrasound images must be computed. One endocardial image technique for registering the X-ray and ultrasound images uses ventriculography-derived LV chamber anatomy in combination with the same chamber imaged with ultrasound for registration. However, patients undergoing cardiac resynchronization therapy are typically extremely fragile and are in heart failure, and therefore are often unable to tolerate large volume contrast agent injections that are commonly required of procedures such as ventriculography. Ventriculography-based registration of X-ray and ultrasound images is therefore problematic for CRT patients with poor cardiac and renal function.
The approach of the present invention avoids ventriculography entirely, and is more clinically-viable in situations where patients cannot tolerate large volume contrast opacification.
One form of the present invention is a ventricular epicardium registration method involving (1) a representation of one or more anatomical features invisible within ultrasound images of a ventricular epicardium of a heart, (2) an identification of the anatomical feature(s) visible within X-ray images of the ventricular epicardium of the heart, and (3) a registration of the ultrasound images and the X-ray images of the ventricular epicardium based on the representation of the anatomical feature(s) invisible within the ultrasound images and the identification of the anatomical feature(s) visible within the X-ray images. Examples of the anatomical features include, but are not limited to, a portion or an entirety of an epicardial surface and a coronary sinus vein.
A second form of the present invention is a multimodality registration system comprising a processor and memory in communication with the processor wherein the memory stores programming instructions executable by the processor to (1) represent one or more anatomical features invisible within ultrasound images of a ventricular epicardium of the heart, (2) identify the anatomical feature(s) visible within X-ray images of the ventricular epicardium of the heart, and (3) register the ultrasound images and the X-ray images of the ventricular epicardium of the heart based on the representation of the anatomical feature(s) invisible within the ultrasound images and the identification of the anatomical feature(s) visible within the X-ray images.
The foregoing form and other forms of the present invention as well as various features and advantages of the present invention will become further apparent from the following detailed description of various embodiments of the present invention read in conjunction with the accompanying drawings. The detailed description and drawings are merely illustrative of the present invention rather than limiting, the scope of the present invention being defined by the appended claims and equivalents thereof.
The present invention is premised on a recognition that, instead of using ventriculography for delineation of the left and/or right ventricle endocardial surfaces of a heart, ventricular epicardium may be used for location of the left and/or right ventricles of the heart. Specifically, X-ray images of the ventricular epicardium can be automatically, semi-automatically, or manually-segmented to generate a surface model onto which a position of a viable anatomical feature as visualized by the X-ray images can be annotated. Additionally, for three-dimensional ultrasound, large volume imaging can be enabled or multiple smaller volumes can be fused together to capture the shape of the entire ventricular epicardium whereby a viable anatomical feature is often enlarged and possibly visible in ultrasound imaging. If visible in the ultrasound image, a position of the anatomical feature can be automatically, semi-automatically or manually annotated onto the ultrasound images.
As stated above, the X-ray/ultrasound integration strategy of the present invention is based on registration of shared features. For example, as shown in
For example, referring to
The end result of the present invention is a registration of the ultrasound images and the X-ray images to obtain an epicardial surface/coronary venous integration for surgical purposes, such as, for example, the integrated epicardial surface/coronary venous integration 20 shown in
To facilitate a further understanding of the present invention,
Referring to
Specifically, an ultrasound imaging phase P61 of flowchart 60 involves processor 51 executing instructions for representing one or more anatomical features missing in ultrasound images 41. An X-ray imaging phase P62 of flowchart 60 involves processor 51 executing instructions for identifying one or more anatomical features shown in X-ray images 31. And, an image registration phase P63 of flowchart 60 involves processor 51 executing instructions for mapping images 31 and 41 based on the anatomical feature X-ray identification and ultrasound representation. Again, examples of anatomical features include, but are not limited to, epicardial surfaces 11 and 12 and coronary sinus vein 13 as shown in
In practice, ultrasound imaging phase P61 will typically be performed as a pre-operative event while X-ray imaging phase P62 and image registration phase P63 will be performed as operational events. Nonetheless, for purposes of the present invention, phases P61-P63 can be practiced as necessary to perform any applicable cardiovascular procedure.
A flowchart 70 shown in
Upon completion of stages S72 and S73 if applicable, a stage S74 of flowchart 70 involves processor 51 defining one or more segments of the three-dimensional epicardial shell that can be used to match the convex hull segment(s) defined during stage S83 of flowchart 80, and a stage S75 of flowchart 70 involves processor 51 annotating a position of coronary sinus vein 13 on the three-dimensional epicardial shell. Again, the position of coronary sinus vein 13 includes spatial location coordinates of coronary sinus vein 13, and/or angular orientation coordinates of coronary sinus vein 13.
A flowchart 80 shown in
A flowchart 90 shown in
In further alternative embodiments, additional intrinsic landmarks (e.g., an anatomical landmark 21 shown in
The result is a ventricular shell/coronary venous model integration (e.g., endocardial shell/coronary venous model integration 20 shown in
For example,
Referring again to
For example, referring to
Referring to
While the embodiments of the invention disclosed herein are presently considered to be preferred, various changes and modifications can be made without departing from the spirit and scope of the invention. The scope of the invention is indicated in the appended claims, and all changes that come within the meaning and range of equivalents are intended to be embraced therein.
Claims
1. A ventricular epicardium registration method (60), comprising:
- (P61) a representation of at least one anatomical feature invisible within ultrasound images (41) of the ventricular epicardium of the heart (10); and
- (P62) an identification of the at least one anatomical feature visible within X-ray images (31) of a ventricular epicardium of a heart (10);
- (P63) a registration of the X-ray images (31) and the ultrasound images (41) of the ventricular epicardium of the heart (10) based on the representation of the at least one anatomical feature invisible within the ultrasound images (41) and the identification of the at least one anatomical feature visible within the X-ray images (31).
2. The ventricular epicardium registration method (60) of claim 1, wherein the at least one anatomical feature includes at least one of an epicardial surface (11, 12) and a coronary sinus vein (13) of the heart (10).
3. The ventricular epicardium registration method (60) of claim 1, wherein (P61) the representation of the at least one anatomical feature invisible within ultrasound images (41) of the ventricular epicardium of the heart (10) includes:
- (S72) a generation of a statistical model of a first anatomical feature derived from a library of at least cardiac dataset.
4. The ventricular epicardium registration method (60) of claim 3, wherein (P61) the representation of the at least one anatomical feature invisible within ultrasound images (41) of the ventricular epicardium of the heart (10) further includes:
- (S73) a mapping of the statistical model of the first anatomical feature within the ultrasound images (41).
5. The ventricular epicardium registration method (60) of claim 3, wherein the library of at least cardiac dataset includes at least one of a computer tomography dataset and a magnetic resonance dataset.
6. The ventricular epicardium registration method (60) of claim 1, wherein (P61) the representation of the at least one anatomical feature invisible within ultrasound images (41) of the ventricular epicardium of the heart (10) includes:
- (S101) a mapping at least one fiducial point identifiable within the ultrasound images (41) and a library of at least one cardiac dataset into a common reference space.
7. The ventricular epicardium registration method (60) of claim 6, wherein (P61) the representation of the at least one anatomical feature invisible within ultrasound images (41) of the ventricular epicardium of the heart (10) further includes:
- (S102) a computation of a mean position of a first anatomical feature in the common reference space relative to the at least one fiducial point.
8. The ventricular epicardium registration method (60) of claim 7, wherein (P61) the representation of the at least one anatomical feature invisible within ultrasound images (41) of the ventricular epicardium of the heart (10) further includes:
- (S73) an identification of the first anatomical feature within the ultrasound images (41).
9. The ventricular epicardium registration method (60) of claim 8, wherein (S73) the statistical model mapping of the first anatomical feature within the ultrasound images (41) further includes:
- (S103) a registration of the mean position of the first anatomical feature invisible within the ultrasound images (41).
10. The ventricular epicardium registration method (60) of claim 6, wherein the library of at least cardiac dataset includes at least one of a computer tomography dataset and a magnetic resonance dataset.
11. A multimodality registration system (50), comprising:
- a processor (51); and
- a memory (52) in communication with the processor (51), wherein the memory (52) stores programming instructions executable by the processor (51) to: (P61) represent at least one anatomical feature invisible within ultrasound images (41) of the ventricular epicardium of the heart (10); and (P62) identify the at least one anatomical feature visible within X-ray images (31) of a ventricular epicardium; (P63) register the X-ray images (31) and the ultrasound images (41) of the ventricular epicardium based on the representation of the at least one anatomical feature invisible within the ultrasound images (41) and on the identification of the at least one anatomical feature visible within the X-ray images (31).
12. The ventricular epicardium registration system (50) of claim 11, wherein the at least one anatomical feature includes at least one of an epicardial surface (11, 12) and a coronary sinus vein (13) of the heart (10).
13. The ventricular epicardium registration system (50) of claim 11, wherein (P61) the representation of the at least one anatomical feature invisible within ultrasound images (41) of the ventricular epicardium of the heart (10) includes:
- (S72) a generation of a statistical model of a first anatomical feature derived from a library of at least cardiac dataset.
14. The ventricular epicardium registration system (50) of claim 13, wherein (P61) the representation of the at least one anatomical feature invisible within ultrasound images (41) of the ventricular epicardium of the heart (10) further includes:
- (S73) a mapping of the statistical model of the first anatomical feature within the ultrasound images (41).
15. The ventricular epicardium registration system (50) of claim 13, wherein the library of at least cardiac dataset includes at least one of a computer tomography dataset and a magnetic resonance dataset.
16. The ventricular epicardium registration system (50) of claim 11, wherein (P61) the representation of the at least one anatomical feature invisible within ultrasound images (41) of the ventricular epicardium of the heart (10) includes:
- (S101) a mapping at least one fiducial point identifiable within the ultrasound images (41) and a library of at least one cardiac dataset into a common reference space.
17. The ventricular epicardium registration system (50) of claim 16, wherein (P61) the representation of the at least one anatomical feature invisible within ultrasound images (41) of the ventricular epicardium of the heart (10) further includes:
- (S102) a computation of a mean position of a first anatomical feature in the common reference space relative to the at least one fiducial point.
18. The ventricular epicardium registration system (50) of claim 17, wherein (P61) the representation of the at least one anatomical feature invisible within ultrasound images (41) of the ventricular epicardium of the heart (10) further includes:
- (S73) a mapping of a statistical model of the first anatomical feature within the ultrasound images (41).
19. The ventricular epicardium registration system (50) of claim 18, wherein (S73) the statistical model mapping of the first anatomical feature within the ultrasound images (41) further includes:
- (S103) a registration of the mean position of the first anatomical feature invisible within the ultrasound images (41).
20. The ventricular epicardium registration system (50) of claim 16, wherein the library of at least cardiac dataset includes at least one of a computer tomography dataset and a magnetic resonance dataset.
Type: Application
Filed: Dec 12, 2008
Publication Date: Oct 7, 2010
Applicant: KONINKLIJKE PHILIPS ELECTRONICS N.V. (EINDHOVEN)
Inventors: Raymond Chan (San Diego, CA), Robert Manzke (Sleepyhollow, NY), Sandeep Dalal (Cortlandtmanor, NY), Francois Tournoux (PARIS)
Application Number: 12/746,184
International Classification: G06K 9/00 (20060101);